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Prosthesis, Volume 5, Issue 1 (March 2023) – 24 articles

Cover Story (view full-size image): In this work, we propose to assess modern hand prostheses through the evaluation of the prosthesis users’ movement quality during a functional task. In order to strike a balance between the accuracy of camera-based motion capture and the clinical feasibility of such an assessment, we suggest using inertial magnetic measurement units (IMMU) for capturing relevant kinematic data. We formulate requirements for the design of functional tasks in such an assessment and present a suggestion for a functional task together with a set of IMMU-derived outcome measures. We assess the feasibility of the test procedure and whether the outcome measures are sensitive to the deviations between a group of prosthesis users and able-bodied participants. View this paper
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19 pages, 787 KiB  
Review
Chemically Activated Glass-Ionomer Cements as Bioactive Materials in Dentistry: A Review
by John Makanjuola and Sanjukta Deb
Prosthesis 2023, 5(1), 327-345; https://doi.org/10.3390/prosthesis5010024 - 17 Mar 2023
Cited by 9 | Viewed by 4639
Abstract
The prospect of repair, regeneration, and remineralisation of the tooth tissue is currently transitioning from the exploratory stages to successful clinical applications with materials such as dentine substitutes that offer bioactive stimulation. Glass-ionomer or polyalkenoate cements are widely used in oral healthcare, especially [...] Read more.
The prospect of repair, regeneration, and remineralisation of the tooth tissue is currently transitioning from the exploratory stages to successful clinical applications with materials such as dentine substitutes that offer bioactive stimulation. Glass-ionomer or polyalkenoate cements are widely used in oral healthcare, especially due to their ability to adhere to the tooth structure and fluoride-releasing capacity. Since glass-ionomer cements exhibit an inherent ability to adhere to tooth tissue, they have been the subject of modifications to enhance bioactivity, biomineralisation, and their physical properties. The scope of this review is to assess systematically the modifications of glass-ionomer cements towards bioactive stimulation such as remineralisation, integration with tissues, and enhancement of antibacterial properties. Full article
(This article belongs to the Special Issue Bioactive Materials for Dental and Maxillofacial Repair)
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17 pages, 6220 KiB  
Article
Influence of the Printing Orientation on Parallelism, Distance, and Wall Thickness of Adjacent Cylinders of 3D-Printed Surgical Guides
by Aisha Ali, Hossein Bassir and Rafael Delgado-Ruiz
Prosthesis 2023, 5(1), 310-326; https://doi.org/10.3390/prosthesis5010023 - 13 Mar 2023
Cited by 3 | Viewed by 1860
Abstract
This in-vitro study aimed to evaluate the influence of the printing orientation on parallelism, distance, and thickness between adjacent cylinders of 3D-printed surgical guides. CAD software was used to design a surgical guide with two adjacent parallel cylinders (reference); the design was saved [...] Read more.
This in-vitro study aimed to evaluate the influence of the printing orientation on parallelism, distance, and thickness between adjacent cylinders of 3D-printed surgical guides. CAD software was used to design a surgical guide with two adjacent parallel cylinders (reference); the design was saved as standard tessellation software (STL) and 63 samples were printed using three different orientations (0, 45, and 90 degrees). A metrology digital microscope was used to measure the distance, the angle and the thickness of the guides cylinders. Afterwards, the printed guides were scanned and cloud comparison software was used to compare STL files from the printed guides against the reference CAD model. One-way analysis of variance and Tukey test were used for multiple comparisons between groups and significance was p < 0.05. The printing orientation affected the distance between cylinders, the parallelism and the wall thickness. In addition, there were global deviations in all printing orientations. Printing with 90 degrees orientation produced almost-parallel cylinders but walls thicker than the reference model; all the cylinders converged toward the coronal but printing at 0 degrees produced the closest distance to the reference value. Within the limitations of this experimental in-vitro study it can be concluded that all the printing orientations influence the angle, the distance, and the thickness between adjacent cylinders of a surgical guide. Printing at 90 degrees produces the best global correspondence with the master model. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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15 pages, 631 KiB  
Article
Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial
by Beatriz Pardal-Peláez, Abraham Dib, Yasmina Guadilla, Javier Flores-Fraile, Norberto Quispe-López and Javier Montero
Prosthesis 2023, 5(1), 295-309; https://doi.org/10.3390/prosthesis5010022 - 13 Mar 2023
Cited by 1 | Viewed by 1929
Abstract
This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the [...] Read more.
This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 ± 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 ± 32.7%) than in the immediate loading group (8.3 ± 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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13 pages, 685 KiB  
Review
The Success Rate of the Adhesive Partial Fixed Prosthesis after Five Years: A Systematic Review
by Maria Catarina Santos, Luis Azevedo, Patrícia Fonseca, Pedro Couto Viana, Filipe Araújo, Eduardo Villarinho, Gustavo Vicentis Oliveira Fernandes and André Correia
Prosthesis 2023, 5(1), 282-294; https://doi.org/10.3390/prosthesis5010021 - 7 Mar 2023
Cited by 4 | Viewed by 2398
Abstract
Objective: Evaluation of the success and/or survival rates of resin-bonded fixed partial dentures (RBFPDs) reported in the scientific literature with a minimum average observation time of five years. Materials and Methods: Search conducted in Pubmed, Web of Science, and Cochrane databases in free-text [...] Read more.
Objective: Evaluation of the success and/or survival rates of resin-bonded fixed partial dentures (RBFPDs) reported in the scientific literature with a minimum average observation time of five years. Materials and Methods: Search conducted in Pubmed, Web of Science, and Cochrane databases in free-text format and MESH terms, until May 2021. The random-effects model was used for the estimated survival rate, percentage per year of estimated failure, and existing complications for the meta-analysis. Study heterogeneity was assessed by the inconsistency test (I2) and study quality by the Downs and Black scale. Results: Eleven articles were included, with 687 participants and 783 RBFPDs, with a mean observation time of 8.2 years, with success rates mentioned in three articles and survival rates reported in nine articles. A total of 142 failures were reported for 783 prostheses, the most frequent being debonding. The estimated failure rate was between 0.53% and 5.10% per year. The studies were of sufficient quality. In the meta-analysis, the survival rates showed a significant result (p < 0.001), with moderate heterogeneity (I2 = 58.76%). Conclusions: Within the limitations of this research, mainly related to the heterogeneity of the studies and their quality, it seems possible to conclude that RBFPDs are a viable clinical option for the rehabilitation of patients with single edentulous spaces, mainly when using a single retainer and a zirconia-ceramic prosthesis. Full article
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18 pages, 3738 KiB  
Article
Testing the Use of Advanced Upper Limb Prostheses: Towards Quantifying the Movement Quality with Inertial-Magnetic Measurement Units
by Andreas W. Franzke, Morten B. Kristoffersen, Dario Farina, Corry K. van der Sluis, Raoul M. Bongers and Alessio Murgia
Prosthesis 2023, 5(1), 264-281; https://doi.org/10.3390/prosthesis5010020 - 24 Feb 2023
Cited by 1 | Viewed by 2620
Abstract
Background: A thorough assessment of upper limb prostheses could help facilitate their transfer from scientific developments into the daily lives of users. Ideally, routine clinical testing would include assessments of upper limb function using motion-capturing technology. This is particularly relevant for the state-of-the-art [...] Read more.
Background: A thorough assessment of upper limb prostheses could help facilitate their transfer from scientific developments into the daily lives of users. Ideally, routine clinical testing would include assessments of upper limb function using motion-capturing technology. This is particularly relevant for the state-of-the-art upper limb prostheses. Methods: We designed a test based on an activity of daily life (“tray-task”) which could be completed outside the laboratory, and developed a set of outcome measures aimed at characterizing the movement quality. For this purpose, kinematics of the thorax and the humerus were captured with an inertial–magnetic measurement unit (IMMU) motion-capture system. Six prosthesis users and ten able-bodied participants were recruited to test the feasibility of the proposed assessment procedure and to evaluate the outcome variables. Results: All participants completed the test either at home or in our lab. The prosthesis users needed more time to complete the task and showed a larger range of motion in the thoracic flexion and a smaller range of motion in the humeral elevation, compared to the able-bodied participants. Furthermore, the prosthesis users’ movements were less smooth and characterized by less stable coordination patterns between the humerus and thorax. Conclusion: A new test method and associated outcome variables have been proposed. Full article
(This article belongs to the Special Issue Design, Control, and Biomechanics of Prosthetic Limbs)
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13 pages, 1365 KiB  
Article
Morton’s Extension on Hallux Rigidus Pathology
by Rubén Sánchez-Gómez, Juan Manuel López-Alcorocho, Almudena Núñez-Fernández, María Luz González Fernández, Carlos Martínez-Sebastián, Ismael Ortuño-Soriano, Ignacio Zaragoza-García and Álvaro Gómez-Carrión
Prosthesis 2023, 5(1), 251-263; https://doi.org/10.3390/prosthesis5010019 - 21 Feb 2023
Cited by 3 | Viewed by 2833
Abstract
Study design, case-control study: Background, Morton’s extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have [...] Read more.
Study design, case-control study: Background, Morton’s extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied pulled tension forces neither in subjects with HR. Objectives: This study sought to understand how ME’s orthotics with three different thicknesses could influence the kinematic first MPJ by measuring hallux dorsiflexion using Jack’s test and a digital algometer with a rigid strip anchored to the iron hook’s extremity and comparing subjects with healthy first MPJ mobility to those with HR. We aimed to clarify whether tension values were different between healthy and HR subjects. Methods: Fifty-eight subjects were selected, of whom thirty were included in the case group according to HR criteria and twenty-eight were included in the control group. A digital algometer (FPX®® 25, Wagner Instruments®®, Greenwich, CT, USA) was used to assess the pulled tension values (kgf) of the first MPJ during Jack’s test. Results: The pulled tension values were highly reliable (ICC > 0.963). There were no statistically significant differences between the pulled tension values for the different ME conditions in the case (p = 0.969) or control (p = 0.718) groups. However, as it’s expected, there were statistically significant differences comparing all pulled tension values between case and control group subjects (p < 0.001). Conclusions: Different ME’s thicknesses had no influence on the pulled effort applied during the dorsiflexion Jack’s test between the healthy and HR groups; therefore, it can be prescribed without joint-care danger. In addition, it is proven that there is greater resistance to performing Jack’s test in the HR group than in the healthy group, regardless of ME’s orthotics. Furthermore, it is shown that the digital algometer device is a valid tool to detect the first MPJ restriction and is more reliable than other tests. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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17 pages, 4704 KiB  
Article
Bioengineering Applied to Oral Implantology, a New Protocol: “Digital Guided Surgery”
by Luca Fiorillo, Agron Meto and Marco Cicciù
Prosthesis 2023, 5(1), 234-250; https://doi.org/10.3390/prosthesis5010018 - 17 Feb 2023
Cited by 8 | Viewed by 2093
Abstract
Rehabilitative dentistry has made enormous progress in recent years, not only due to the advent of new implant-prosthetic methods, but also thanks to new information technologies that support the doctor. This study aims to present a new implant protocol that involves the application [...] Read more.
Rehabilitative dentistry has made enormous progress in recent years, not only due to the advent of new implant-prosthetic methods, but also thanks to new information technologies that support the doctor. This study aims to present a new implant protocol that involves the application of bioengineering methods. With the application of the finite element analysis, it is possible to evaluate the distribution of the forces of a fixture and possible implant rehabilitation on each patient, even before performing the surgery. This protocol provides for the combination of radiographic images and three-dimensional files to obtain predictable results on possible rehabilitation, guiding its planning in the best possible way. Surely, the evolution of machines and computers will enable the surgeon to carry out and maintain these protocols in a chair-side manner, and to carry out safe and predictable rehabilitations. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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13 pages, 16130 KiB  
Case Report
Computer-Guided Osteotomy with Simultaneous Implant Placement and Immediately Loaded Full-Arch Fixed Restoration: A Case Report
by Claudia Todaro, Michael Cerri, Gaetano Isola, Andrea Manazza, Stefano Storelli, Ruggero Rodriguez y Baena and Saturnino Marco Lupi
Prosthesis 2023, 5(1), 221-233; https://doi.org/10.3390/prosthesis5010017 - 9 Feb 2023
Cited by 2 | Viewed by 1648
Abstract
Aim: This case report aims to illustrate a clinical protocol that allows for the rehabilitation of patients requiring extensive osteotomy, simultaneous implant placement, and full-arch, screwed-in prosthetics in one session. This protocol allows for the improvement of the aesthetics and functionality of the [...] Read more.
Aim: This case report aims to illustrate a clinical protocol that allows for the rehabilitation of patients requiring extensive osteotomy, simultaneous implant placement, and full-arch, screwed-in prosthetics in one session. This protocol allows for the improvement of the aesthetics and functionality of the fixed implant-supported prosthesis through the preoperative planning of all surgical procedures, including osteotomy, and of the prosthesis through the application of 3D-printing technology for the creation of surgical templates and prostheses. Methods: This case report concerns a 72-year-old patient, ASA1, who, following diagnosis, the establishment of a treatment plan, and the provision of informed consent, opted for an immediate, full-arch rehabilitation of the lower arch. The digital planning stage started with the correct positioning of the fixtures. The proper bone levels were found and used to guide the creation of the provisional screwed-in prothesis. Two templates with the same supports (landmarks/pins) were then 3D-printed: a positioning template, including a slit to assist the surgeon during the osteotomy, and a surgery template to assist the surgeon during the implants’ positioning. A screwed-in prosthesis encased in resin C&B MFH (NEXTDENT®, Soesterberg, The Netherlands) was delivered. Minimal occlusal adjustments were performed. Results: In a single clinical session, through careful planning and the pre-operative 3D printing of a prosthesis, a temporary implant-supported prosthetic rehabilitation was possible in a case that required an extended osteotomy. Clinically, the correspondence between the virtual design phase and the final realization was consistent. At a functional level, the provisional prosthesis required minimal occlusal adjustments and the DVO values obtained in the immediate post-operative period were found to be comparable to those of the virtual design. By planning the final position of the bone and the implants in advance, it was possible to deliver a full-arch prothesis with proper implant emergence, occlusal vertical dimensions, and occlusal relationship. Conclusion: This fully digital protocol allows the clinician to preview and plan the osteotomy and implant surgery as well as the delivery of the temporary, immediately loaded, complete, fixed prosthesis in patients who are candidates for post-extraction surgery with the need for severe osteotomy. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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13 pages, 2626 KiB  
Article
Zygomatic Implants Research: A Scientometric Analysis from 1990 to 2021
by Marina Ramal-Sanchez, Felice Lorusso, Angela Taraschi, Luca Valbonetti, Nicola Bernabò, Calogero Bugea and Antonio Scarano
Prosthesis 2023, 5(1), 208-220; https://doi.org/10.3390/prosthesis5010016 - 7 Feb 2023
Cited by 1 | Viewed by 1369
Abstract
Zygomatic implants imply the use of the zygoma as the implant anchorage and have been proposed as a valuable alternative to the invasive classical procedures in cases of severe maxillary atrophy. Despite the numerous manuscripts published in this field, a quantitative analysis of [...] Read more.
Zygomatic implants imply the use of the zygoma as the implant anchorage and have been proposed as a valuable alternative to the invasive classical procedures in cases of severe maxillary atrophy. Despite the numerous manuscripts published in this field, a quantitative analysis of the research products to infer the trends and the status identification of this specific issue was missing, as well as an objective map of this area. Thus, the present scientometric study analyzed all the research papers published within the interval 1990–2021 that included the keyword “zygomatic implants”. Research papers containing the keywords “zygomatic implants” were collected using Web of Science and analyzed with Cytoscape 3.7.2 and Sci software. A total of 654 studies were published between 1990 and 2020, reaching up to 11639 citations in total, with a mean of 17.8 citations per research study. Data show that the number of publications per year is rapidly increasing, as well as the sum of citations per year. While the USA was identified as the most productive country in this field, followed by Italy, Spain, and Brazil, the National Natural Science Foundation of China stands up as the major funding agency, followed by the National Institutes of Health (NIH) in the USA and the United States Department of Health and Human Services. The analysis of the keywords showed that “zygomatic fractures” represents the most common word within this field, with “complications” as the most recent keyword and “screws” as the keyword used for the longest time. The map of science representing the authors and their collaborations highlighted the existence of multiple small-size research groups that contribute to scientific production, forming highly clustered structures that do not collaborate between them. The present scientometric analysis demonstrates the rising interest in using the zygomatic implants technique as an alternative to the classical ones. The obtained data suggest that the scientific community involved in the study of such a field is highly fragmented, emphasizing the lack of communication among the scientists and research groups. Full article
(This article belongs to the Special Issue Bioactive Materials for Dental and Maxillofacial Repair)
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11 pages, 3991 KiB  
Article
Same-Day Digital Dentistry Restorative Workflow for Single Immediate Provisionalization of Narrow-Diameter Implants: An Exploratory Prospective Study
by Janina Golob Deeb, Nitya G. Reddy, Liam J. Hopfensperger, April L. Harris and Sompop Bencharit
Prosthesis 2023, 5(1), 197-207; https://doi.org/10.3390/prosthesis5010015 - 6 Feb 2023
Cited by 1 | Viewed by 2042
Abstract
This study evaluated the two-year clinical outcomes of 3.1 mm diameter dental implants, immediately provisionalized and later restored using same-day dentistry, in 10 patients receiving 11 narrow-diameter (3.1 mm) single implants. Each implant was placed and immediately restored with a provisional crown after [...] Read more.
This study evaluated the two-year clinical outcomes of 3.1 mm diameter dental implants, immediately provisionalized and later restored using same-day dentistry, in 10 patients receiving 11 narrow-diameter (3.1 mm) single implants. Each implant was placed and immediately restored with a provisional crown after placement. At least 2 months after placement, the implant was restored with a prefabricated titanium abutment and an all-ceramic crown using a same-day dentistry protocol. Clinical outcomes, including apical bone loss, probing depths, gingival index, and surgical and prosthetic complications, were documented. There was no implant failure over the course of two years. No surgical complications were reported. Two cases lost provisional crowns. One crown needed to be remade due to esthetic concern. The cumulative two-year survival rate of the implants was 100%. Implant bone loss after two years of functional loading was −0.56 ± 0.54 mm and −0.32 ± 0.68 mm for mesial and distal crestal bone, respectively. Two prosthetic complications included recementation of a crown and remaking of a crown. This exploratory study suggests that immediate provisionalization and a same-day restorative dentistry digital workflow protocol for narrow-diameter implants appear to be predictable clinical procedures with no reported surgical complications and minimal prosthetic complications. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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15 pages, 6215 KiB  
Article
The Effect of the Poly-Articulated Prosthetic Hand on Shoulder and Trunk Compensatory Movements during Manipulation and Grasp Tasks
by Andrea Giovanni Cutti, Federico Morosato, Emanuele Gruppioni, Gregorio Teti, Lorenzo De Michieli and Cosimo Gentile
Prosthesis 2023, 5(1), 182-196; https://doi.org/10.3390/prosthesis5010014 - 5 Feb 2023
Cited by 1 | Viewed by 2081
Abstract
Conventional myoelectric prosthetic hands only offer a basic tri-digital pinch. Transradial amputees need to compensate for this lack of function with altered kinematics at the shoulder and trunk that might expose them to an increased risk of musculoskeletal injuries. A poly-articulated prosthetic hand [...] Read more.
Conventional myoelectric prosthetic hands only offer a basic tri-digital pinch. Transradial amputees need to compensate for this lack of function with altered kinematics at the shoulder and trunk that might expose them to an increased risk of musculoskeletal injuries. A poly-articulated prosthetic hand may reduce the physical compensatory movements and close the gap between the sound and the prosthetic side. Six male transradial amputees completed four standardized reach-and-grasp activities with their tri-digital, poly-articulated and sound side hands. Trunk, shoulder girdle, scapula and humerus kinematics were measured with an optoelectronic system. Differences between hands were analyzed in terms of the amplitude of motion, the duration of the altered kinematics over the motion cycle, peak-to-peak amplitude and time to complete the activity. An overall score was defined, which assigned three points when the kinematics of a joint angle was altered for over 41% of the motion cycle, two points between 11 ÷ 40% and one point between 1 ÷ 10%; thus, a lower score indicates less variation from normal kinematics. Despite no changes in times, tri-digital vs. sound hand scored 93 points, tri-digital vs. poly-articulated hands scored 49 and poly-articulated vs. sound hand scored 28, supporting the hypotheses of the poly-articulated hand positively affects shoulder and trunk kinematics. Full article
(This article belongs to the Special Issue Design, Control, and Biomechanics of Prosthetic Limbs)
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15 pages, 14776 KiB  
Article
Evolving 3D-Printing Strategies for Structural and Cosmetic Components in Upper Limb Prosthesis
by Albert Manero, John Sparkman, Matt Dombrowski, Peter Smith, Pavan Senthil, Spencer Smith, Viviana Rivera and Albert Chi
Prosthesis 2023, 5(1), 167-181; https://doi.org/10.3390/prosthesis5010013 - 3 Feb 2023
Cited by 3 | Viewed by 7513
Abstract
The evolution of prosthetic limbs continues to develop, with novel manufacturing techniques being evaluated, including additive manufacturing. Additive manufacturing (AM), or 3D-printing, holds promise for enabling personalized and tailored medical device options. The requirements for personalized medicine, coupled with the limitations of small-batch [...] Read more.
The evolution of prosthetic limbs continues to develop, with novel manufacturing techniques being evaluated, including additive manufacturing. Additive manufacturing (AM), or 3D-printing, holds promise for enabling personalized and tailored medical device options. The requirements for personalized medicine, coupled with the limitations of small-batch manufacturing, have made the technique viable for exploration. In this manuscript, an approach is presented for incorporating additive manufacturing for prostheses, both as a final part and in applications as an intermediate manufacturing step. As a result, through the use of these methods a multi-gesture capable electromyographic prosthesis was designed and manufactured, currently being evaluated in clinical trials for pediatric patients. This paper explored the results of this unique method of applying additive manufacturing techniques, and assessed how the blend of different manufacturing techniques improved performance and reduced device weight. Creating unique and aesthetic cosmetic coverings for the device was achieved through using additive manufacturing as an intermediate manufacturing component and, then, applying thermoforming. Cosmesis components saw a 33% reduction in weight from this change in manufacturing. The approach is explored to blend multiple manufacturing techniques to create cosmesis components and structural components for the prosthesis. The techniques serve the design intent to reduce reported challenges with upper limb prosthesis devices and to encourage device retention. Recommendations for manufacturing strategies are discussed, including the limitations. Full article
(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)
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19 pages, 2380 KiB  
Review
Infection of Vascular Prostheses: A Comprehensive Review
by Davide Costa, Michele Andreucci, Nicola Ielapi, Giuseppe Filiberto Serraino, Pasquale Mastroroberto, Umberto Marcello Bracale and Raffaele Serra
Prosthesis 2023, 5(1), 148-166; https://doi.org/10.3390/prosthesis5010012 - 2 Feb 2023
Cited by 4 | Viewed by 5379
Abstract
Vascular graft or endograft infection (VGEI) is a complex disease that complicates vascular-surgery and endovascular-surgery procedures and determines high morbidity and mortality. This review article provides the most updated general evidence on the pathogenesis, prevention, diagnosis, and treatment of VGEI. Several microorganisms are [...] Read more.
Vascular graft or endograft infection (VGEI) is a complex disease that complicates vascular-surgery and endovascular-surgery procedures and determines high morbidity and mortality. This review article provides the most updated general evidence on the pathogenesis, prevention, diagnosis, and treatment of VGEI. Several microorganisms are involved in VGEI development, but the most frequent one, responsible for over 75% of infections, is Staphylococcus aureus. Specific clinical, surgical, radiologic, and laboratory criteria are pivotal for the diagnosis of VGEI. Surgery and antimicrobial therapy are cornerstones in treatment for most patients with VGEI. For patients unfit for surgery, alternative treatment is available to improve the clinical course of VGEI. Full article
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18 pages, 1593 KiB  
Article
3D Printing in LMICs: Functional Design for Upper Limb Prosthetics in Uganda
by Ali Hussaini, Peter Kyberd, Benedict Mulindwa, Robert Ssekitoleko, William Keeble, Laurence Kenney and David Howard
Prosthesis 2023, 5(1), 130-147; https://doi.org/10.3390/prosthesis5010011 - 1 Feb 2023
Cited by 1 | Viewed by 3089
Abstract
Meeting the needs of persons with upper limb loss in Uganda requires an understanding of the needs and desires of the local population. The limitations of resources and accessibility for the individual gave rise to a focused design methodology for delivering a culturally [...] Read more.
Meeting the needs of persons with upper limb loss in Uganda requires an understanding of the needs and desires of the local population. The limitations of resources and accessibility for the individual gave rise to a focused design methodology for delivering a culturally acceptable solution using 3D Printing technology. A series of co-design activities were held in Uganda and provided direct feedback to drive the design of two prototypes based on acceptable aesthetics and priority Activities of Daily Living. Two terminal device prototypes were 3D printed in the UK. These can be directly attached to a standard proximal socket thread. The passive hand was printed in a flexible filament and the prehensor was printed in a durable impact resistant material. Local researchers in Uganda have similar 3D printers, filaments, and assembly hardware, which allowed for concurrent development and refinement of the prototypes. Local participation provides a rich user feedback environment to understand which elements of prosthetic device design are integral to delivering acceptable prosthetics solutions for fabrication in Uganda. 3D printing can provide a viable route to addressing the needs of the user. The proposed terminal devices are now in the process of being printed locally for field testing. Full article
(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)
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17 pages, 6574 KiB  
Article
Decellularized Porcine Pericardium Enhances Autologous Vascularized Matrix as a Prosthesis for Left Ventricular Full-Wall Myocardial Reconstruction
by Tanja Meyer, Serghei Cebotari, Gudrun Brandes, Dagmar Hartung, Frank Wacker, Monika Theis, Tim Kaufeld, Igor Tudorache, Ingo Nolte, Axel Haverich and Tobias Schilling
Prosthesis 2023, 5(1), 113-129; https://doi.org/10.3390/prosthesis5010010 - 1 Feb 2023
Cited by 2 | Viewed by 1517
Abstract
Regenerative grafts for myocardial reconstruction are often mechanically not stable enough to withstand the left ventricle’s high blood pressure. Hence, decellularized pericardium may serve as a stabilizing structure for biological myocardium prostheses. The efficacy of detergent- and enzyme-based protocols to decellularize porcine pericardium [...] Read more.
Regenerative grafts for myocardial reconstruction are often mechanically not stable enough to withstand the left ventricle’s high blood pressure. Hence, decellularized pericardium may serve as a stabilizing structure for biological myocardium prostheses. The efficacy of detergent- and enzyme-based protocols to decellularize porcine pericardium was compared. Then, the decellularized pericardium was employed for a primary cover of a transmural left ventricular defect in minipigs (n = 9). This pericardium patch was applied to mitigate the high-pressure load on an autologous stomach tissue, which was utilized as a regenerative tissue prosthesis. Decellularization of the porcine pericardium with deoxycholic acid (DOA)- and enzyme-based protocols (trypsin/EDTA) removed 90% of the original cells (p < 0.001). The trypsin/EDTA protocol significantly altered the matrix architecture compared to the DOA protocol. There were no infections or clinical signs of graft rejection following the transplantation of the decellularized pericardium and the autologous segment of the stomach in the surviving animals (n = 7). A good left ventricular function could be detected via MRI six months following surgery. The biological integration of the graft into the host’s tissue was found histologically. The stabilization of initially fragile grafts with decellularized pericardium facilitates the application of regenerative myocardial prostheses even on the left ventricle. Full article
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11 pages, 297 KiB  
Article
Effects of Disinfectants Used for COVID-19 Protection on the Color and Translucency of Acrylic Denture Teeth
by Nick Polychronakis, Aikaterini Mikeli, Panos Lagouvardos and Gregory Polyzois
Prosthesis 2023, 5(1), 102-112; https://doi.org/10.3390/prosthesis5010009 - 20 Jan 2023
Cited by 1 | Viewed by 1669
Abstract
Purpose: This study investigated the color and translucency changes of denture teeth after immersion in disinfectant solutions. Material and Methods: Ten denture teeth (Optostar/Heraeus Kulzer) were immersed in nine different solutions (ethanol 78%, 2-propanol 75%, NaOCl 1%, H2O2 0.5%, glutaraldehyde [...] Read more.
Purpose: This study investigated the color and translucency changes of denture teeth after immersion in disinfectant solutions. Material and Methods: Ten denture teeth (Optostar/Heraeus Kulzer) were immersed in nine different solutions (ethanol 78%, 2-propanol 75%, NaOCl 1%, H2O2 0.5%, glutaraldehyde 2.6%, chlorhexidine 0.12%, povidone-iodine 1%, Listerine Naturals, distilled water) for 3 min to 180 min. L*, a* and b* values were measured before and after their immersion with a contact colorimeter (FRU-WR18/Shenzhen Wave Electronics) over a white and black background, and ΔΕ*ab, ΔΕ00, ΔΤPab and ΔTP00 differences were calculated from baseline measurements. Two-way rmANOVA was used to analyze the data for significant differences among solutions and immersion times at α = 0.05. Results: ΔΕ*ab and ΔΕ00 values were significantly different only across solutions (p < 0.001), with mean differences from 0.24 to 1.81 ΔΕ*ab or 0.12 to 0.93 in ΔΕ00 units. TPab or TP00 translucency parameters showed no significant differences among intervals or solutions (p > 0.050). The mean changes ranged from −0.43 to 0.36 ΔTPab units, and −0.22 to 0.27 in ΔTP00 units. Conclusions: Most of the solutions had no significant effect on the color of teeth compared to the water group. Chlorhexidine 0.12%, glutaraldehyde 2.6% and Listerine produced significant color changes, especially at 180 min. The translucency of teeth was not affected by the solutions, regardless of the type and immersion time. Full article
2 pages, 158 KiB  
Editorial
Acknowledgment to the Reviewers of Prosthesis in 2022
by Prosthesis Editorial Office
Prosthesis 2023, 5(1), 100-101; https://doi.org/10.3390/prosthesis5010008 - 16 Jan 2023
Viewed by 876
Abstract
High-quality academic publishing is built on rigorous peer review [...] Full article
12 pages, 2360 KiB  
Article
Friction Optimization of Talc Powder-Reinforced Elastomers for Prosthetic Foot Application
by Muhammad Khafidh, Donny Suryawan, Lilis Kistriyani, Muhammad Naufal and Rifky Ismail
Prosthesis 2023, 5(1), 88-99; https://doi.org/10.3390/prosthesis5010007 - 12 Jan 2023
Cited by 1 | Viewed by 1837
Abstract
Patients with lower limb amputation usually use prosthetic feet. Elastomeric material is an important part of prosthetic feet since it can determine their safety and lifetime. The elastomeric material should have high friction for safety, and at the same time it should have [...] Read more.
Patients with lower limb amputation usually use prosthetic feet. Elastomeric material is an important part of prosthetic feet since it can determine their safety and lifetime. The elastomeric material should have high friction for safety, and at the same time it should have low wear for a longer lifetime. This research is aimed to study the optimum formulation of talc-powder-reinforced silicone elastomer to obtain high friction during sliding contact. The Taguchi orthogonal array L9 formula is used to achieve the aforementioned goal. The experiments use multiple parameters, namely, the type of silicone, the type of surface texture, the amount of catalyst, and the amount of talc powder. The results show that the combination of RTV 683, a smooth texture, 4% of catalyst, and 60% of talc powder is the most optimum composition to obtain the highest frictional force. It has a higher friction force in comparison with the imported products, and, at the same time, it has comparable wear with the imported products. The hardness of the optimized materials is comparable with the imported products. However, the tensile and tear strengths of the optimized materials need to be improved. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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15 pages, 5660 KiB  
Article
Development and Effectiveness Testing of a Novel 3D-Printed Multi-Material Orthosis in Nurses with Plantar Foot Pain
by Komal Chhikara, Sarabjeet Singh Sidhu, Shubham Gupta, Sakshi Saharawat, Chitra Kataria and Arnab Chanda
Prosthesis 2023, 5(1), 73-87; https://doi.org/10.3390/prosthesis5010006 - 11 Jan 2023
Cited by 5 | Viewed by 2278
Abstract
Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely [...] Read more.
Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely to be multi-factorial, with many associated risk factors including increased hours of standing. Orthoses and insoles are often recommended to plantar foot pain patients, however with minimal scientific advancements and limited customizations. In this study, a novel 3D-printed multi-material customized foot orthosis was developed, and its effectiveness on plantar foot pain reduction and functional ability improvement was studied in the nursing population. A total of thirty-six subjects were recruited and were randomized into two groups. The experimental group received the novel 3D-printed multi-material customized foot orthosis, whereas the control group received the standard-of-care (or traditional) intervention. Pre-test and the post-test scores of pains, functional ability and plantar pressure were observed using SPSS software. Improvements were observed in both of the groups; however, better improvements were seen in the experimental group. Overall, the novel 3D printing-based customized foot orthosis showed significant efficacy in reducing plantar foot pain and pressure, and also in increasing functional ability in the nursing population as compared to the traditional method. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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13 pages, 6356 KiB  
Article
Translucent and Highly Toughened Zirconia Suitable for Dental Restorations
by Seiji Ban, Yuta Yasuoka, Tsutomu Sugiyama and Yuzo Matsuura
Prosthesis 2023, 5(1), 60-72; https://doi.org/10.3390/prosthesis5010005 - 10 Jan 2023
Viewed by 1556
Abstract
Background: There is a limit to improving the characteristics of zirconia with only one kind of stabilizing element such as yttrium. The purpose of this study is to systematically evaluate the effects of various co-doped elements on mechanical and optical properties and to [...] Read more.
Background: There is a limit to improving the characteristics of zirconia with only one kind of stabilizing element such as yttrium. The purpose of this study is to systematically evaluate the effects of various co-doped elements on mechanical and optical properties and to develop a novel composition of zirconia with enough properties to apply to dental restorations. Methods: Forty-four kinds of zirconia were prepared by combining trivalent cations yttrium (Y) and ytterbium (Yb), and pentavalent cations niobium (Nb) and tantalum (Ta) oxide as stabilizers. The combined contents ranged from 0 to 5.6 mol% for Y2O3, 0 to 4.2 mol% for Yb2O3, 0 to 1.5 mol% for Nb2O5, and 0 and 1.2 mol% for Ta2O5. These specimens were determined for fracture toughness and opacity. X-ray diffraction studies were undertaken to evaluate the microstructural change. Results: The present study revealed that adding of the trivalent cations Y and Yb reduced fracture toughness and opacity, whereas the addition of pentavalent cations Nb and Ta to zirconia stabilized with trivalent cations increased both properties. There was no clear difference in the effects of Y and Yb, Nb, and Ta. Conclusions: Considering many factors, the following composition is optimal: 3–4.2 mol% Y2O3 and/or Yb2O3 stabilized zirconia with up to 1.5 mol% Nb2O5 has sufficiently high fracture toughness values and sufficiently high translucency suitable for dental restorations. Full article
(This article belongs to the Special Issue Novel Zirconia Materials Applied in Dental Prostheses)
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12 pages, 20272 KiB  
Article
Mechanical Properties of Translucent Zirconia: An In Vitro Study
by Luan Mavriqi and Tonino Traini
Prosthesis 2023, 5(1), 48-59; https://doi.org/10.3390/prosthesis5010004 - 10 Jan 2023
Cited by 1 | Viewed by 2093
Abstract
Background: The introduction of translucent zirconia has improved mimetics: nevertheless, a reduction in the mechanical performance was registered. The study aim was to investigate the mechanical characteristics of a high-translucent zirconia used for monolithic restorations before and after the aging process compared [...] Read more.
Background: The introduction of translucent zirconia has improved mimetics: nevertheless, a reduction in the mechanical performance was registered. The study aim was to investigate the mechanical characteristics of a high-translucent zirconia used for monolithic restorations before and after the aging process compared to a low-translucent zirconia. Methods: A total of 23 specimens were used in the present study. Group A (n = 10) was made of a high-translucent Y-TZP; group B (n = 7) was made of a low-translucent Y-TZP and finally group C (n = 6) was an aged high-translucent Y-TZP. Flexural strength, fracture toughness, brittleness, microcrack’s propagation and grain size were analyzed. Results: The Vickers hardness was: 1483 ± 187 MPa (group C); 1102 ± 392 MPa (group A); 1284 ± 32 MPa (group B). The flexural strength was: 440 (±96.2) MPa (group C); 427 (±59.5) MPa (group A); 805 (±198.4) MPa (group B). The fracture toughness was: 5.1 (±0.7) MPa.m1/2 (group C); 4.9 (±0.9) MPa.m1/2 (group A); 8.9 (±1.1) MPa.m1/2 (group B). The brittleness was: 295 (±42.8) (group C), 230.9 (±46.4) (group A) and 144.9 (±20.3) (group B). The grain size was: 2.75 (±1.2) µm2 (group A); 0.16 (±0.05) µm2 (group B); 3.04 (±1.1) µm2 (group C). Conclusions: The significant reduction in the mechanical properties of high-translucent zirconia, compared to the traditional one, suggests their use in the anterior/lateral area (up to premolars). Full article
(This article belongs to the Special Issue Novel Zirconia Materials Applied in Dental Prostheses)
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13 pages, 2843 KiB  
Article
Marginal and Internal Fit of Monolithic Zirconia Crowns Fabricated by Using Two Different CAD-CAM Workflows: An In Vitro Study
by Vahap Çin, Ayça Deniz İzgi, Ediz Kale and Burak Yilmaz
Prosthesis 2023, 5(1), 35-47; https://doi.org/10.3390/prosthesis5010003 - 5 Jan 2023
Cited by 2 | Viewed by 3107
Abstract
Objectives: Few studies have evaluated the marginal fit of computer-aided design—computer-aided manufacturing (CAD-CAM) monolithic zirconia crowns fabricated through completely digital workflow; however, the internal fit of these restorations is not well known. The purpose of this in vitro study was to evaluate the [...] Read more.
Objectives: Few studies have evaluated the marginal fit of computer-aided design—computer-aided manufacturing (CAD-CAM) monolithic zirconia crowns fabricated through completely digital workflow; however, the internal fit of these restorations is not well known. The purpose of this in vitro study was to evaluate the marginal and internal fit of monolithic zirconia crowns fabricated by using digital workflow, including intraoral scanner (IOS) scans, and compare the results to those of a semi-digital workflow, which combined conventional impressions, poured casts, and extraoral scanner (EOS) scanning. Materials and methods: A typodont right mandibular first molar was prepared for a complete-coverage ceramic crown and scanned using an IOS. The conventional impressions of the preparation were also made, and stone casts were poured and scanned by using an EOS. Virtual models were generated for both workflows, and identical virtual anatomic contour crowns were designed using CAD software. Monolithic zirconia crowns were fabricated for both IOS (ZI; n = 10) and EOS (ZE; n = 10) groups. The silicon replica technique was used to evaluate the marginal and internal fit of the crowns. Measurements were made at 13 points on buccolingual and mesiodistal cross-sections per specimen with a ×6.5 to ×50 zoom stereo microscope. The results from both groups were statistically compared using the Independent Samples t-tests and the Mann–Whitney U test (α = 0.05). Results: Mean gap values at all measurement locations for ZE were significantly higher than those for ZI (p ≤ 0.002). Overall mean values ranged between 29 and 43 µm (median: 28–42 µm) for ZI and 42 and 75 µm (median: 43–77 µm) for ZE. Conclusion: Completely digital workflow through intraoral scans provided significantly better marginal and internal fit for CAD-CAM monolithic zirconia crowns compared with the semi-digital workflow, where stone casts obtained from conventional impressions were scanned with an EOS. Yet, both workflows provided an acceptable marginal and internal fit for CAD-CAM monolithic zirconia molar crowns (<120 µm). Clinical Relevance: Completely digital workflow using IOS scans may be advantageous for the fabrication of CAD-CAM monolithic zirconia crowns as favorable results can be obtained with less material waste and potentially shortened overall treatment time as the impression files can be transferred to the production facility electronically. The results need to be corroborated with clinical studies. Full article
(This article belongs to the Special Issue Novel Zirconia Materials Applied in Dental Prostheses)
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22 pages, 48586 KiB  
Article
3D Printed Energy Return Elements for Upper Limb Sports Prosthetics
by Jung Wook Park, Ben Greenspan, Taylor Tabb, Eric Gallo and Andreea Danielescu
Prosthesis 2023, 5(1), 13-34; https://doi.org/10.3390/prosthesis5010002 - 4 Jan 2023
Cited by 3 | Viewed by 3709
Abstract
Prosthetics are an extension of the human body and must provide functionality similar to that of a non-disabled individual to be effective. Sports prosthetics such as the Flex-Foot Cheetah from Össur have demonstrated the value of creating devices that both provide mechanical support [...] Read more.
Prosthetics are an extension of the human body and must provide functionality similar to that of a non-disabled individual to be effective. Sports prosthetics such as the Flex-Foot Cheetah from Össur have demonstrated the value of creating devices that both provide mechanical support and introduce passive energy return to mimic forces otherwise produced at joints. These energy return mechanisms have not yet been demonstrated for upper limb prosthetics but could improve their effectiveness and provide a greater range of motion and control. Using multi-material 3D printing technology, we extend energy return components to upper limb prosthetics by developing novel force-sensing springs and applying them to a basketball prosthetic. The 3D-printed springs compensate for the forces otherwise generated by wrist and finger flexion while measuring the mechanical deflection. We discuss design guidelines, methods for integrated 3D printed energy return within prosthetics, and broader applications in assistive technologies. Full article
(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)
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12 pages, 825 KiB  
Perspective
Molecular Diagnosis of Osteoarticular Implant-Associated Infection: Available Techniques and How We Can Use Them
by Llanos Salar-Vidal, Álvaro Auñón and Jaime Esteban
Prosthesis 2023, 5(1), 1-12; https://doi.org/10.3390/prosthesis5010001 - 28 Dec 2022
Cited by 5 | Viewed by 1904
Abstract
Despite recent advances during the last few years, microbiological diagnosis of prosthetic joint infections remains a challenge. Molecular biology techniques have been developed to try to overcome this problem, and recently, many of them have become available for many laboratories. Some of them, [...] Read more.
Despite recent advances during the last few years, microbiological diagnosis of prosthetic joint infections remains a challenge. Molecular biology techniques have been developed to try to overcome this problem, and recently, many of them have become available for many laboratories. Some of them, especially commercial multiplex PCR-based assays and universal 16S rDNA homemade PCR assays, are now available in many laboratories. Moreover, new technologies have appeared, especially metagenomics and next-generation sequencing. These techniques have demonstrated their potential in many studies but appear to be experimental at present. A few studies have evaluated the possible use of these methods in the clinical routine, and a review of the critical aspects for the selection of a molecular method (accuracy, complexity, cost) was performed. Finally, a proposal for a protocol that includes molecular biology techniques was made according to the literature published in this field. In conclusion, molecular biology techniques are ready to be used in the clinical routine of a microbiology laboratory, but their use must be carried out in accordance with the many special characteristics of each laboratory. In all cases, the interpretation of the results must be conducted by a multidisciplinary team with experience in the management of these patients. Full article
(This article belongs to the Special Issue State of Art in Hip and Knee Replacement)
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